Community Dialogue is Critical to Health and Social Care

The roll out of new health and social care partnerships has been a critical part of the Scottish Government’s commitment to bring together healthcare and social services into a more seamless service, catering for the needs of the individual patient. However, a recent report by the Scottish Parliament’s Health and Sport Committee has shone a light on the lack of good communication between the new integrated authorities (also known as Integrated Joint Boards) and both the voluntary sector and the communities they serve.

Back in 2014, legislation was passed under The Public Bodies (Joint Working) Act to bring together the work of local authorities and the NHS in a new partnership arrangement. The buzzwords at the time were around community engagement, personalised care and co-production. The aim was to develop a new, integrated approach to health and social care and to remove artificial divides between the two.

Trouble was spotted at the outset. During the creation of the legislation a partnership between the NHS and local authorities left little room for the voluntary sector or housing organisations. Community interests were to be defended largely by local authorities and, in a small concession to the voluntary sector, by Third Sector Interfaces. These community groups were not, however, to be granted voting rights on boards and it was difficult to comprehend how the myriad of community issues were to be represented by one or two people.

The new Integrated Authorities have had a difficult birth. Over two years in, most are still finding their feet. And while there are areas of good practice and a genuine willingness to hear new ideas, there is little sign of the more radical change that some expected. While this was always going to be a long and difficult process which would take a lot of internal communications and team building, external communications seem to have been left aside.

It is perhaps then of little surprise to read in the Health and Sport Committee report that many in the voluntary sector and those from patient and community groups have felt marginalised. Without voting rights and a direct say in the new authorities, many feel they have not been able to have a real say in how they are run. People are still very confused about what the new authorities do, how they are run, and how to access them.

Few people on the street even know they exist and what they do. The tools for communication are in many cases not being well used. The websites of many of the new authorities are difficult to access and the information is often unclear and full of jargon. Indigestible newsletters sit gathering dust in libraries.  Little wonder then that communities don’t know what’s going on.

Integrated authorities can, and no doubt will, be a force for good, but they need to change their focus now and reach out to both patients and the communities they serve through platforms and language that will resonate with local communities. That means creating a dialogue with residents and local groups, rather than the controlled communications we witness today.

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